COVID-19 Sırasında Gelişen Karaciğer Hasarı Ne Kadar Önemli?

Year 2021, , 239 - 243, 30.12.2021

Berat Ebik , Nazım Ekin Ferhat Bacaksız , Jihat Kılıç

https://doi.org/10.18678/dtfd.947189

Abstract

Amaç: Bu çalışma, koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) nedeniyle hastaneye yatırılan hastalarda karaciğer fonksiyon bozukluğu prevalansını incelemeyi ve yoğun bakım ünitesine yatış ve mortaliteyi öngörmede karaciğer fonksiyon bozukluğunun rolünü araştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Önceden bilinen bir kronik karaciğer hastalığı olmayan ve polimeraz zincir reaksiyonu testi ile doğrulanmış COVID-19 pozitif olan toplam 2168 hasta, hafif ve şiddetli COVID-19 olarak gruplara ayrıldı. Karaciğer hasarı gelişiminin COVID-19’un seyrine ve prognozuna etkisi araştırıldı.
Bulgular: Hafif COVID-19’lu hastaların %26,3’ünde (n=461) ve şiddetli COVID-19’lu hastaların %45,3’ünde (n=189) karaciğer enzimlerinde yükselme meydana geldi. En yüksek ALT ve AST artışları, antibiyotikler ile birlikte birden fazla ilaç kullanan hastalarda tespit edildi (p<0,001). Hafif COVID-19’lu hastaların %1,4’ünde (n=25) ve şiddetli COVID-19’lu hastaların %6,5’inde (n=27) şiddetli hepatit gelişti (p<0,001). Şiddetli COVID-19’lu hastalarda, ALT ile albumin arasında zayıf düzeyde negatif bir korelasyon (p=0,017; r=-0,497) saptanırken, bilirubin ile zayıf düzeyde pozitif bir korelasyon (p=0,024; r=0,352), ferritin ile orta düzeyde pozitif bir korelasyon (p=0,016; r=0,504) ve INR ile zayıf düzeyde pozitif bir korelasyon (p=0,022; r=0,383) olduğu saptandı.
Sonuç: Sonuçlar, COVID-19 hastalarının %30’unda farklı şiddette karaciğer fonksiyon testlerinde bozulma meydana geldiğini ve şiddetli COVID-19 hastalarında karaciğer hasarının daha yaygın olduğunu göstermektedir. Ayrıca COVID-19 sırasında meydana gelen karaciğer hasarının yoğun bakım gereksinimi ve ölüm riskini artıran bir etken olduğu da belirlenmiştir.

Keywords

COVID-19, karaciğer, prognoz

How Important Is Liver Damage During COVID-19?

Abstract

Aim: The present study aimed to examine the prevalence of liver dysfunction in patients hospitalized due to coronavirus disease 2019 (COVID-19) and to investigate the role of liver dysfunction in predicting intensive care unit admission and mortality.
Material and Methods: A total of 2168 patients who had no previously known chronic liver disease and were found to be COVID-19 positive on polymerase chain reaction test were divided into mild and severe COVID-19 groups. The effect of the development of liver damage on the course and prognosis of COVID-19 was investigated.
Results: Elevated liver enzymes developed in 26.3% (n=461) of the patients with mild COVID-19 and in 45.3% (n=189) of the patients with severe COVID-19. The highest ALT and AST elevation was detected in patients using more than one drug with antibiotics (p<0.001). Severe hepatitis developed in 1.4% (n=25) of the patients with mild COVID-19 and 6.5% (n=27) of the patients with severe COVID-19 (p<0.001). There was a weak negative correlation between ALT and albumin (p=0.017, r=-0.497), while a weak positive correlation with bilirubin (p=0.024, r=0.352), a moderate positive correlation with ferritin (p=0.016, r=0.504), and a weak positive correlation with INR (p=0.022, r=0.383) were found in patients with severe COVID-19.
Conclusion: The results showed that 30% of COVID-19 patients had impaired liver function of varying severity and that liver damage was more common in patients with severe COVID-19. It was also determined that liver damage occurring during COVID-19 was an indicator of intensive care requirement and the mortality risk.

Keywords

COVID-19, liver, prognosis

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